Transcription of APPLICATION REDUCED TRANSIT FARE IDENTIFICATION …
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Example: tourism industry
APPLICATION REDUCED TRANSIT FARE IDENTIFICATION …
PART I - TO BE COMPLETED BY APPLICANT (Please print or type)PART II - TO BE COMPLETED BY PHYSICIAN OR AUTHORIZED AGENCY (Please print or type)MT-301 (5-18) APPLICATION REDUCED TRANSIT fare IDENTIFICATIONCARD REDUCED TRANSIT fare PROGRAM for persons WITH certify that the above named individual qualifies for a disability REDUCED fare TRANSIT IDENTIFICATION Card because: (please check as manyreasons as are applicable. For further explanation please see reverse side)._____ (1) The person possesses a Medicare Card and is under 65 years of (2) The person cannot negotiate a flight of stairs or escalator with ease, reasonable speed, and/or without aid from another (3) The person cannot board or leave a TRANSIT vehicle with ease, reasonable speed, and/or
MT-301 (5-18) APPLICATION REDUCED TRANSIT FARE IDENTIFICATION CARD REDUCED TRANSIT FARE PROGRAM FOR PERSONS WITH DISABILITIES www.penndot.gov I certify that the above named individual qualifies for a disability Reduced Fare Transit Identification Card because: (please check as many reasons as are applicable.
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